Purpose: Esophageal atresia and /or tracheo-esophageal fistula (EA/TEF) is a rare condition with significant potential for development of complications after post-repair discharge. Our objective was to identify characteristics associated with morbidity and mortality of infants with EA/TEF. Methods: This is a follow up study of the patients who were repaired for EA/TEF between Jan 2008 and Aug 2013 in our institute. A retrospective review of charts of those infants was performed. Data were recorded regarding survival at 2 yrs., discharge weight , growth parameters at 2 yr. age (height, weight, head circumference), any delayed development (motor or speech) as noted in the chart, hearing impairment, complications of surgical procedure (esophageal stricture, no. of dilation required, asthma, wheezing, pneumonia, tracheomalacia, dysphagia), and any other surgical procedure. Data are presented as means or medians. Categorical variables were compared with chi squared analysis or Fisher's exact test and for continuous variables t test was used. Results: Of the 27 babies admitted with for EA/TEF, 23 infants were discharged after repair. 74% were type C, followed by type A (15%), type E (7.5%) type B (3.7%) and none type D. One infant was lost to follow-up. Survival at 2 yr. was 21/22 (95%). 55% (12/22) of patients were males and 46% were Caucasians, with mean birth weight of 2412 g and median gestation of 36 wk. Mean weight at discharge was 3545 g. At 2 yrs. Follow-up 47.3% (9/19), 75% (12/16) 50% (7/14) had weight, height and head circumference < 10th percentile respectively. 13 (59%) patients developed stricture, who required dilatation, median number of dilation required was1 (range 1-9). One patient developed recurrent TE fistula.15 patients had been diagnosed gastroesophageal reflux and were on treatment (PPI or H2 blocker), 7 had diagnosis of recurrent wheezing, 3 diagnosed to have asthma and 6 had at least 1 episode of pneumonia which required treatment with antibiotics. No patient developed chest wall deformity, 3 had diagnosis of tracheomalacia after bronchoscopy. 4 had gross motor delay, 5 speech delay and 2 diagnosed for hearing impairment. 11/22 patients still needed g-tube at 2yr age. 4 tracheostomy and cardiac surgery were performed in 4 patients each. Only birth weight was significantly associated with stricture development (P value 0.0436). Conclusion: Our survival rate at two years is comparable to that reported in the literature. More than half of the discharged babies developed strictures and needed esophageal dilatation. A significant number (50%) still required g-tube feedings at 2 years age.
Outcomes at 2 Year Follow up of Infants After Tracheo-esophageal Fistula/esophageal Atresia repair
- Views Icon Views
- Share Icon Share
- Search Site
Himadri Nath, Kate Savoie, Eunice Huang, Ajay Talati; Outcomes at 2 Year Follow up of Infants After Tracheo-esophageal Fistula/esophageal Atresia repair. Pediatrics January 2018; 141 (1_MeetingAbstract): 546. 10.1542/peds.141.1MA6.546
Download citation file: